Travel Nurse RN - Care Manager - $2,587 per week

About the role

Specialty: Care Manager. Discipline: RN. Duration: 13 weeks. Hours: 36 hours per week. Shift: 12 hours, days. Employment Type: Travel. Location: Hyannis, Massachusetts (Cape Cod Hospital). Setting: Acute-care hospital. Focus: Case Management, Utilization Review and Discharge Planning. Ideal candidate: highly organized, comfortable working independently, able to manage changing priorities in a fast‑paced hospital environment; strong communication, negotiation, patient advocacy, and interdisciplinary collaboration skills are essential. Prime Time Healthcare Nursing is a leading provider of traveling healthcare professionals nationwide, specializing in the placement of RNs, LPNs, CNAs, and Allied Health professionals.

Responsibilities

• Screen new admissions daily for discharge‑planning needs
• Complete identified initial assessments within one business day
• Document initial assessments and continued‑stay reviews using InterQual
• Reassess patients approximately every three days or when clinical or caregiver circumstances change
• Determine the appropriate inpatient or observation level of care
• Perform utilization review for the assigned unit
• Monitor length of stay and identify cases at risk for denial
• Refer cases to the physician advisor when medical‑necessity criteria are not met
• Issue HINN notices and reinstatement letters when appropriate
• Coordinate discharge appeals and explain adverse coverage decisions
• Communicate concurrent clinical information to third‑party payers
• Collaborate with physicians and the interdisciplinary care team
• Participate in daily rounds and patient‑care conferences
• Develop safe discharge plans and coordinate transfers to facilities, agencies and community resources
• Address complex psychosocial, financial and legal needs through appropriate referrals
• Support medical coding by obtaining required diagnostic and procedural information
• Ensure care plans align with patient needs, available benefits and covered services

Requirements

• Active Massachusetts RN license
• Minimum 3 years of acute‑care hospital or case‑management experience within the past 5 years
• Recent discharge‑planning and utilization‑review experience within the past 4 years
• Working knowledge of InterQual or a comparable system
• Strong knowledge of payer and regulatory requirements
• Proficiency with electronic documentation and healthcare software

Qualifications

• BSN preferred
• Case Management, CPUM or related specialty certification preferred

Skills

• Acute‑care experience
• InterQual proficiency

Benefits

• 401k retirement plan
• Health savings account
• Referral bonus
• Medical benefits
• Dental benefits
• Vision benefits